FP Report -- June 1999
AAFP backs bill on doctors' right to negotiate with health plans
A bill in Congress that would allow physicians to bargain collectively with health plans has won AAFP's support.
"Right now, health plans can present a contract to physicians and say, 'Take it or leave it,'" said AAFP Board Chair Neil Brooks, M.D., of Rockville, Conn.
The Quality Health Care Coalition Act, H.R. 1304, would fix that. Under the bill, health professionals could analyze contracts, talk with each other about what's good and bad, and negotiate terms.
"It's a matter of quality of care," said Brooks. "If an insurance company offers you a contract that forces you to see an unreasonable number of patients a day, and you're not offering proper services to your patients, then the company is not only decreasing physician income but actually hurting patient care."
The bill would give health professionals the same protections from antitrust regulations as employees covered by the National Labor Relations Act.
"Now, if two or three of us talk about a contract, we're per se in violation of antitrust regulations," said Brooks. "That's been a tremendous threat hanging over our heads."
However, the bill precludes the right to strike. In that sense, said Brooks, "this is not a unionization bill."
H.R. 1304 was introduced March 25 by Reps. Tom Campbell, R-Calif., and John Conyers, D-Mich. No companion bill had been introduced in the Senate at press time.
Physicians have tried to get negotiating clout through, for example, independent physician associations, said Brooks, but federal rules now restrict IPAs' negotiating ability.
The AAFP Board of Directors decided April 27, during its meeting in Kansas City, Mo., that the Academy would back the bill. About 30 other medical groups endorse it, including the American Medical Association. The Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education oppose the bill on the grounds that it might apply to residents, but Campbell's staff said the bill is not intended to affect residents.
"The greatest opposition to the bill will come from insurance companies," predicted Brooks.
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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